Healthcare Provider Details

I. General information

NPI: 1932843455
Provider Name (Legal Business Name): NC EYE SURGEONS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2022
Last Update Date: 04/25/2022
Certification Date: 04/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S MCPHERSON CHURCH RD STE 106
FAYETTEVILLE NC
28303-4913
US

IV. Provider business mailing address

416 IVY ARBOR WAY
HOLLY SPRINGS NC
27540-4812
US

V. Phone/Fax

Practice location:
  • Phone: 704-560-6520
  • Fax:
Mailing address:
  • Phone: 704-560-6520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FARAAZ KHAN
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 704-560-6520